1st May 2025, Kathmandu
The Government of Nepal has introduced a new change to the health insurance system. Citizens can now use hospitals near where they live to get insurance services. This means they no longer have to travel to their original registration place to access care.
Nepal Health Insurance Local Access
Cabinet Approves New Rules
The Cabinet approved this reform on the proposal of Health and Population Minister Pradip Paudel. The amendment to the Health Insurance Regulation will now let insured individuals set up their First Point of Contact (Prasthan Bindu) at their current location.
Before this change, people had to go back to the location where they first registered for insurance services. This process was especially difficult for those who had moved to another city.
Problem With the Old System
For example, a person from Kanchanpur who was living in Kathmandu still had to contact their original hospital back home to get a referral. This created delays and caused frustration. Many citizens had been requesting the government to fix this issue.
Minister Paudel responded to these public concerns. He proposed that people should be allowed to set their service point wherever they currently live. On Wednesday, the Cabinet agreed and approved this change.
Now, Use Services from Where You Live
With the new rule, citizens can now choose a local hospital as their First Point of Contact. This hospital can issue referrals and offer services under the health insurance scheme.
This removes the hassle of traveling long distances. People will save time, money, and energy.
Minister Paudel said, “This will help insured people who had to travel far just for a referral. Many citizens were asking for this.”
Faster Access to Services
In addition, the waiting time to use health insurance has also been reduced. Earlier, people had to wait three months after registering for the scheme. Now, they can start using it in just one month.
This change will make the system more effective. It will also encourage more people to join the health insurance program.
First Contact Point in All Local Levels
The government will now set up a First Point of Contact in every local government area. Until now, some areas still lacked these contact points. That created confusion and limited access to services.
By making this change, the government hopes to improve health insurance for everyone.
Better Services for All
Minister Paudel believes these reforms will improve public access to healthcare. He said the changes make the insurance system more practical and citizen-friendly.
“This is a step toward making health insurance simple and useful for all,” he said. “Now, people won’t have to go far for basic services.”
Looking Ahead
The Ministry of Health expects more citizens will use health insurance now. With fewer barriers, the system can reach more people and offer better care.
These reforms aim to make health services more local, timely, and easier to use—right where people live.
For more: Nepal Health Insurance Local Access